Sutures and Stitches

• General Information:
  • What is a suture?
    • Any strand of material used to ligate blood vessels or to approximate tissues
  • How are sutures sized?
    • By diameter;:
      • Stated as a number of 0’s:
        • The higher the number of 0’s, the smaller the diameter:
          • For example a 2-0 suture has larger diameter than 5-0 suture
  • Which is thicker, 1-0 suture or 3-0 suture?
    • 1-0 suture
• Classification:
  • What are the two most basic suture types?
    • Absorbable and non-absorbable
  • What is an absorbable suture?
    • Suture that is completely broken down by the body:
      • Dissolving suture
  • What is a nonabsorbable suture?
    • Suture is not broken down:
      • Permanent suture
• Sutures:
  • Catgut:
    • What are “catgut” sutures made of?
      • Purified collagen fibers from the intestines of healthy cows or sheep
    • What are the two types of gut sutures?
      • Plain and chromic
    • What is the difference between plain and chromic gut?
      • Chromic gut is treated with chromium salts (chromium trioxide):
        • Which results in more collagen cross-links:
          • Making the suture more resistant to breakdown by the body
• Vicryl® Suture
  • What is it?
    • Absorbable, braided, and multi-filamentous copolymer of lactide and glycoside
  • How long does it retain its strength?
    • 60% at 2 weeks
    • 8% at 4 weeks
  • Should you ever use PURPLE-colored Vicryl® for skin closure?
    • No:
      • It may cause purple tattooing
• PDS®
  • What is it?
    • Absorbable, monofilament polymer of polydioxanone:
      • Absorbable fishing line
  • How long does it maintain its tensile strength?
    • 70% to 74% at 2 weeks
    • 50% to 58% at 4 weeks
    • 25% to 41% at 6 weeks
  • How long does it take to complete absorption?
    • 180 days (6 months)
• What is silk?
  • Braided protein filaments:
    • Spun by the silkworm larva:
      • Known as a nonabsorbable suture
• What is Prolene®?
  • Non-absorbable suture:
    • Used for vascular anastomoses, hernias, abdominal fascial closure
• What is nylon?
  • Non-absorbable “fishing line”
• What is monocryl?
  • Absorbable monofilament
• What kind of suture should be used for the biliary tract or the urinary tract
  • ABSORBABLE:
    • Otherwise the suture will end up as a nidus for stone formation

#Arrangoiz #Teacher Surgeon #CancerSurgeon #SurgicalOncologist #BreastSurgeon #ThyroidSurgeon #ParathyroidSurgeon #HeadandNeckSurgeon #MountSinaiMedicalCenter #MSMC #Miami #Mexico